Use of balloon catheters for intraoperative control of resting myocardial pressure during cardioplegia

Twenty-two patients operated on for aortal, mitral and multivalvular prosthesis under pharmacological cardioplegia were examined for the purpose of monitoring myocardial resting tension by the tensometric method and by using modified balloon catheters. The results demonstrated that the use of the balloon catheters permits making not only qualitative and quantitative assessments of myocardial lesions and a prompt evaluation of the function of the arrested heart but also the initial myocardial contractility and the restoration of myocardial contractility after cardioplegic arrest by controlling the contraction and relaxation myocardial rate.     

Myocardial interstitial glucose and lactate before,during, and after cardioplegic heart arrest

The interstitial fluid of the human myocardium was monitored in 13 patients undergoing aortic valve and/or bypass surgery before, during, and after hypothermic potassium cardioplegia. The regulation of glucose and lactate was studied after sampling with microdialysis. The following questions were addressed. 1). Is the rate of transcapillary diffusion the limiting step for myocardial uptake of glucose before or after cardioplegia? 2). Does cold potassium cardioplegia induce a critical deprivation of glucose and/or accumulation of lactate in the myocardium? Before cardioplegia, interstitial glucose was approximately 50% of the plasma level (P < 0.001). Interstitial glucose decreased significantly immediately after induction of cardioplegia and remained low (1.25 +/- 0.25 mM) throughout cardioplegia. It was restored to precardioplegic levels 1 h after release of the aortic clamp. Interstitial glucose then decreased again at 25 and 35 h postoperatively to the levels observed during cardioplegia. Interstitial lactate decreased immediately after induction of cardioplegia but returned to basal level during the clamping period. At 25 and 35 h, interstitial lactate was significantly lower than before and during cardioplegia. Glucose transport over the capillary endothelium is considered rate limiting for its uptake in the working heart but not during cold potassium cardioplegia despite the glucose deprivation following perfusion of glucose-free cardioplegic solution. Lactate accumulated during cardioplegia but never reached exceedingly high interstitial levels. We conclude that microdialysis provides information that may be relevant for myocardial protection during open-heart surgery.     

Electrical activity of the heart in anti-ischemic protection of the myocardium

The paper studies electrical activity of the heart during the anti-ischemic protection by cool high-potassium cardioplegic solution based on the blood. Parametres characterising automatism function and the myocardial state of the ventricles practically did not differ from the control data obtained during the experiments without ischemia. Atrioventricular conduction and the atrium myocardium were worse preserved. The positive effects of the papaverine addition to the cardioplegic perfusate has been also shown. The author came to the conclusion that it is necessary to pay special attention to the electrical activity of the supraventricular area of the heart for the adequate evaluation of the cardioplegia.     

Energy metabolism and mechanical recovery after cardioplegia in moderately hypertrophiedrats

It is well established that severe hypertrophy induces metabolic and structural changes in the heart which result in enhanced susceptibility to ischemic damage during cardioplegic arrest while much less is known about the effect of cardioplegic arrest on moderately hypertrophied hearts. The aim of this study was to elucidate the differences in myocardial high energy phosphate metabolism and in functional recovery after cardioplegic arrest and ischemia in mildly hypertrophied hearts, before any metabolic alterations could be shown under baseline conditions.Cardiac hypertrophy was induced in rats by constriction of the abdominal aorta resulting in 20% increase in heart weight/body weight ratio (hypertrophy group) while sham operated animals served as control. In both groups, isolated hearts were perfused under normoxic conditions for 40 min followed by infusion of St.Thomas' Hospital No. 1 cardioplegia and 90 min ischemia at 25øC with infusions of cardioplegia every 30 min. The changes in ATP, phosphocreatine (PCr) and inorganic phosphate (Pi) were followed by³¹ P nuclear magnetic resonance (NMR) spectroscopy. Systolic and diastolic function was assessed with an intraventricular balloon before and after ischemia.Baseline concentrations of PCr, ATP and Pi as well as coronary flow and cardiac function were not different between the two groups. However, after cardioplegic arrest PCr concentration increased to 61.8 ± 4.9 mol/g dry wt in the control group and to 46.3 ± 2.8 mol/g in hypertrophied hearts. Subsequently PCr, pH and ATP decreased gradually, concomitant with an accumulation of Pi in both groups. PCr was transiently restored during each infusion of cardioplegic solution while Pi decreased. PCr decreased faster after cardioplegic infusions in hypertrophied hearts. The most significant difference was observed during reperfusion: PCr recovered to its pre-ischemic levels within 2 min following restoration of coronary flow in the control group while similar recovery was observed after 4 min in the hypertrophied hearts. A greater deterioration of diastolic function was observed in hypertrophied hearts.Moderate hypertrophy, despite absence of metabolic changes under baseline conditions could lead to enhanced functional deterioration after cardioplegic arrest and ischemia. Impaired energy metabolism resulting in accelerated high energy phosphate depletion during ischemia and delayed recovery of energy equilibrium after cardioplegic arrest observed in hypertrophied hearts could be one of the underlying mechanisms.     

Murine Isolated Heart Model of Myocardial Stunning Associated with Cardioplegic Arrest

The following protocol is of use to evaluate impaired cardiac function or myocardial stunning following moderate ischemic insults. The technique is useful for modeling ischemic injury associated with numerous clinically relevant phenomenon including cardiac surgery with cardioplegic arrest and cardiopulmonary bypass, off-pump CABG, transplant, angina, brief ischemia, etc. The protocol presents a general method to model hypothermic hyperkalemic cardioplegic arrest and reperfusion in rodent hearts focusing on measurement of myocardial contractile function. In brief, a mouse heart is perfused in langendorff mode, instrumented with an intraventricular balloon, and baseline cardiac functional parameters are recorded. Following stabilization, the heart is then subject to brief infusion of a cardioprotective hypothermic cardioplegia solution to initiate diastolic arrest. Cardioplegia is delivered intermittently over 2 hr. The heart is then reperfused and warmed to normothermic temperatures and recovery of myocardial function is monitored. Use of this protocol results in reliable depressed cardiac contractile function free from gross myocardial tissue damage in rodents.     

不同温度“钾维普”停搏对幼大鼠心功能的影响

目的：探讨未成熟缺血心脏“钾维普”停搏保护的适宜温度。方法：离体幼大鼠心脏Langendorff法灌流,分5组（n=6—8）。对照组：360C正常灌流170min;36℃（常温）组：正常灌流20rain,灌“钾维普”停搏液（KVe）3min停灌87min（常温停搏90rain）,恢复正常灌流（复灌）60min;32、28、24℃（低温）组：正常灌流15min,5min内分别降温至32、28、24℃,灌KVP3rain停灌87min（低温停搏90min）,复灌60min。实验过程实时监测心率（h／min）、心肌张力（g）、收缩力（g）、最大收缩速度（dr／dtmax）、最大舒张速度（-dT／dtmax）及冠脉流量（drop/min）反映心功能。结果：与对照组相比,各组KVP停搏50min后心脏张力均增高;与低温停搏相比,常温停搏的心脏不良挛缩迟缓、复灌后心脏张力、心率、收缩力、冠脉流量恢复好（P〈0．05）。结论：未成熟缺血心脏常温“钾维普”停搏保护效果优于低温停搏。     

Improvement of preservation with cardioplegia induced by heat stress is mediated by calcitonin gene-related peptide

Previous studies have shown improvement of preservation with cardioplegia by calcitonin gene-related peptide (CGRP)-induced preconditioning. Therefore we examined the hypothesis that endogenous CGRP may be involved in the protection of heat stress against myocardial damages after prolonged cardioplegic arrest in isolated rat heart. Reperfusion after 4 h of hypothermic ischemia caused a decline of cardiac function and an increase of creatine kinase (CK) release. Heat stress induced by pretreatment with whole body hyperthermia (rectal 42 degrees C) for 15 min produced a significant increase in the plasma content of CGRP, an improvement of cardiac function and a decrease in the release of CK. However, after pretreatment with capsaicin (50 mg/kg, s.c.) to deplete CGRP in cardiac sensory nerves, the plasma concentration of CGRP was no longer increased and the cardioprotection afforded by heat stress was abolished. These findings suggest that improvement of preservation with cardioplegia by heat stress may be mediated by endogenous CGRP in the rat.     

心脏晶体停搏液和冷血停搏液不同灌注方法对心肌保护的评价

目的：评估二种心脏停搏液不同灌注方法对心肌保护作用。方法：30例双瓣患者随机分为冷晶体停搏液间断灌注组(n=10),冷血停搏液间断灌注组(n=10),冷血停搏液持续灌注组(n=10),观察血浆心肌肌钙蛋白T(CnT)、肌酸激酶(CK)、肌酸激酶同工酶(CK—MB)。结果：体外循环后冷晶体停搏液间断灌注组血浆心肌肌钙蛋白T和肌酸激酶、肌酶激酶同工酶较其他2组明显增高;冷血停搏液间断灌注组和冷血停搏液持续灌注组血浆心肌肌钙蛋白T、肌酸激酶、肌酸激酶同工酶无明显差异。结论：冷血停搏液的心肌保护优于冷晶体停搏液,冷血停搏液间断灌注与持续灌注没有明显差异。     

二氮嗪在长时程心脏低温保存中的作用

延长心脏的体外有效保存时间对临床心脏移植具有重要意义。本文旨在研究线粒体ATP敏感性钾通道开放剂二氮嗪(diazoxide,DE)在离体大鼠心脏长时程低温保存中的作用。SD大鼠随机分成5组,包括对照组(单纯Celsior保存液),DE组(Celsior液中含15、30或45μmol／L的DE)和DE 5-HD组[Celsior液中含30μmol／L的DE和100μmol／L的5-羟基葵酸盐(5-hydroxydecanoate,5-HD)]。利用Langendorff离体鼠心灌注法,观察心脏在4℃条件下保存10h后,复灌期血流动力学恢复、冠脉流出液中心肌酶漏出量及心肌水含量变化,并做心肌超微结构检查。结果显示：与对照组比较,DE处理后,复灌期的左心室舒张末期压力明显降低,心率、左心室发展压、左心室压力变化率、冠脉流出量等的恢复率在多个复灌时间点上优于对照组,且能显著减少复灌过程中心肌酶(乳酸脱氢酶、磷酸肌酸激酶及谷草转氨酶)的漏出量,降低心肌水含量;其中30和45μmol／LDE组的保护作用优于15μmol／LDE组;电镜结果显示DE对长时程低温保存心脏的超微结构有较好的保护作用。DE的上述作用可被线粒体ATP敏感性钾通道的特异性阻断剂5-HD所取消。以上结果提示：DE可通过激活线粒体ATP敏感性钾通道显著改善离体大鼠心脏长时程低温保存效果。     

Organ arrest, protection and preservation: natural hibernation to cardiac surgery

Cardiac surgery continues to be limited by an inability to achieve complete myocardial protection from ischemia-reperfusion injury. This paper considers the following questions: (1) what lessons can be learned from mammalian hibernators to improve current methods of human myocardial arrest, protection and preservation? and (2) can the human heart be pharmacologically manipulated during acute global ischemia to act more like the heart of a hibernating mammal? After reviewing the major entropy-slowing strategies of hibernation, a major player identified in the armortarium is maintenance of the membrane potential. The resting membrane potential of the hibernator's heart appears to be maintained close to its pre-torpid state of around -85 mV. In open-heart surgery, 99% of all surgical heart arrest solutions (cardioplegia) employ high potassium (>16 mM) which depolarises the membrane voltage from -85 to around -50 mV. However, depolarising potassium cardioplegia has been increasingly linked to myocyte and microvascular damage leading to functional loss during reperfusion. Our recent work has been borrowed from hibernation biology and is focused on a very different arrest strategy which 'clamps' the membrane near its resting potential and depresses O2 consumption from baseline by about 90%. The new 'polarising' cardioplegia incorporates adenosine and lidocaine (AL) as the arresting combination, not high potassium. Studies in the isolated rat heart show that AL cardioplegia delivered at 37 degrees C can arrest the heart for up to 4 h with 70-80% recovery of the cardiac output, 85-100% recovery of heart rate, systolic pressure and rate-pressure product and 70-80% of baseline coronary flows. Only 14% of hearts arrested with crystalloid St. Thomas' solution No. 2 cardioplegia survived after 4 h. In conclusion, maintenance of the myocardial membrane potential near or close to its resting state appears to be an important feature of the hibernator's heart that may find great utility in surgical arrest and cellular preservation strategies. Identifying and safely turning 'off' and 'on' the entropy-slowing genes to down-regulate the hibernator's heart and applying this to human organs and tissues remains a major challenge for future genomics and proteomics.     

Propofol is cardioprotective in a clinically relevant model of normothermic blood cardioplegic arrest and cardiopulmonary bypass

The general anesthetic propofol has been shown to be cardioprotective. However, its benefits when used in cardioplegia during cardiac surgery have not been demonstrated. In this study, we investigated the effects of propofol on metabolic stress, cardiac function, and injury in a clinically relevant model of normothermic cardioplegic arrest and cardiopulmonary bypass. Twenty anesthetized pigs, randomized to propofol treatment (n = 8) and control (n = 12) groups, were surgically prepared for cardiopulmonary bypass (CPB) and cardioplegic arrest. Doses of warm blood cardioplegia were delivered at 15-min intervals during a 60-min aortic cross-clamped period. Propofol was continuously infused for the duration of CPB and was therefore present in blood cardioplegia. Myocardial biopsies were collected before, at the end of cardioplegic arrest, and 20 mins after the release of the aortic cross-clamp. Hemodynamic parameters were monitored and blood samples collected for cardiac troponin I measurements. Propofol infusion during CPB and before ischemia did not alter cardiac function or myocardial metabolism. Propofol treatment attenuated the changes in myocardial tissue levels of adenine nucleotides, lactate, and amino acids during ischemia and reduced cardiac troponin I release on reperfusion. Propofol treatment reduced measurable hemodynamic dysfunction after cardioplegic arrest when compared to untreated controls. In conclusion, propofol protects the heart from ischemia-reperfusion injury in a clinically relevant experimental model. Propofol may therefore be a useful adjunct to cardioplegic solutions as well as being an appropriate anesthetic for cardiac surgery.     

RAPID HYPOTHERMIC CARDIOPLEGIA AND AIR VENTING WITH AN AORTIC ROOT CANNULA

A newly designed aortic root perfusion cannula (ARC) is described that accomplishes a double purpose. Not only does it allow rapid inflow into the root of the aorta for induction of hypothermic cardioplegia, but it also provides an effective air vent after completion of the procedure. This technique simplifies air venting at the end of open heart operations.     

河蚌外套膜组织培养细胞分泌的珍珠质的药理作用

本文研究河蚌外套膜组织培养细胞分泌珍珠质的药理作用。组织培养后的培养液,能缩短小白鼠出血时间。用组织培养后的培养液及组织块水解液,对大鼠离体子宫及蟾蜍离体心脏收缩有增强作用,对兔离体小肠有抑制作用。这些药理作用与培养液中牛磺酸含量变化一致。实验结果表明,河蚌分泌珍珠质的细胞,在离体人工培养条件下,能旺盛地分泌珍珠质,分泌的珍珠质具有天然珍珠相同的一些药理作用。     

Impact of the new generation coronary care unit.

A 30-bed coronary care unit with facilities for fluoroscopy, haemodynamic monitoring, mechanical heart assistance, and long-term electrocardiographic monitoring operated at a reasonable cost over five years. Much of the work was entrusted to trained nurses, and there was close consultation with cardiac surgeons over those patients who needed catheterisation or surgery. New procedures greatly reduced the numbers of early deaths from cardiac arrest and cardiac failure but had less influence on late mortality. Hospital mortality for all 3353 patients was 6-8%, and for patients under 65 with definite infarction, who were admitted direct it was 5-7%.     

含血停搏液镁离子浓度对未成熟心肌保护的影响

目的 采用幼兔离体心脏模型。模拟临床上可能出现的含血停搏液Ca^2 浓度变化,探讨适宜于未成熟心肌保护的Mg^2 浓度。方法 3-4周龄长耳白兔,依照含血停搏液不同Mg^2 浓度（0.6mmol/L,4.0mmol/L,8.0mmol/L,120mmol/L,16.0mmol/L）随机分为5组,建立Langendorff离体心脏灌注模型。采用Ca^2 浓度1.2-1.5mmol/L的含血停搏液,运用温血停搏液诱导停搏,冷血停搏液间断灌注,低温保护,终末温血停搏液控制性再灌注技术,观察以下指标：1、血流动力学指标;实验前后恢复率;心率,主动脉流量,冠脉流量,心排量,左室收缩压和左室舒张末压;2、心肌含水量;3、冠脉流出液乳酸盐含量;4、心肌肌酸激酶和乳酸脱氢酶漏出率;5、心肌细胞内Na^2 ,Ca^2 含量;6、心肌组织ATP含量;7、心肌组织SOD活性,MDA含量;8、心肌超微结构。结果 1、心率恢复率,主动脉流量恢复率及左室收缩压恢复率组间总体差异无显著性。而冠脉流量恢复率,心排量恢复率和左室舒张末压恢复率以Mg^2 浓度8.0mmol/L和12.0mmol/L为优,0.4mmol/L组最差。2、心肌含水量以Mg^2 浓度8.0mmol/L和12.0mmol/L为最低。3、冠脉流出液乳酸盐含量0.4mmol/L组,8.0mmol/L和12.0mmol/L组高于欺科2组。4、心肌乳本能部氢酶漏出率以8.0mmol/L组最低,而肌酸激酶漏出率以8.0mmol/L和12.0mmol/L组为最低。5、心肌细胞内Na^ 、Ca^2 含量;6、心肌组织ATP含量;7、心肌组织SOD活性,MDA含量;8、心肌超微结构。结果：1、心率恢复率,主动脉流量恢复率及左室收缩压恢复率组间总体差异无显著性。而冠脉流量恢复率,心排量恢复率和左室舒张末压恢复率以Mg^2 浓度8.0mmol/L和12.0mmol/L为优,0.4mmol/L组最差。2、心肌含水量以Mg^2 浓度8.0mmol/L和12.0mmol/L为最低。3、冠脉流出液乳酸盐含量0.4mmol/L组最差。2、心肌含水量以Mg^2 浓度8.0mmol/L和12.0mmol/L为最低。3、冠脉流出液乳桎卤含量0.4mmol/L组,8.0mmol/L和12.0mmol/L组高于其余2组。4、心肌乳酸脱氢酶漏出率以8.0mmol/L组最低,而肌酸激酶漏出率以8.0mmol/L和12.0mmol/L组为最低。5、心肌细胞内Na^2 含量以8.0mmol/L和12.0mmol/L组为最低,而心肌细胞内Ca^2 含量以8.0mmol/L组最低。6、心肌组织ATP含量以12.0mmol/L组为最高。7、心肌组织SOD活性以8.0mmol/L和12.0mmol/L组库最高,而MDA含量各组间总体差异无显著性。8、心肌超微结构;8.0mmol/L和12.0mmol/L组表现为基本正常未成熟心肌超微结构,而0.4mmol/L组超微结构有明显损伤表现。结论 对于未成熟心肌,当采用温血停搏液诱导停搏,冷血停搏液间断灌注,低温保护,温血停搏液终末控制性再灌注技术时,为避免含血停搏液Ca^2 浓度偏高对未成熟心肌的不利影响。应维持含血停搏液中Mg^2 浓度在8-12mmol/L。     

Endothelium of myocardium microvessel under conditions of hypothermia, ischemia, reperfusion and pharmaco-cold cardioplegia with calcium antagonist

Microvessels of the right atrium endothelium were investigated with electron microscope for patients with congenital heart disease receiving surgical treatment under deep perfusionless hypothermia and various methods of pharmaco-cold cardioplegia. In group 1, pharmaco-cold cardioplegia was performed, with hyperosmolar normopotash solution cooled down to 2-4 degrees C. In group 2, the same solution combined with isoptin, a potash-ion blocker, was applied. It has been shown that during global ischemia, stability of ion gradients on plasmalemma of endothelial cells is impaired, irrespective of the composition of cardioplegia solution. Alongside with this, ultrastructural reactions in group 1 proceed towards hyperosmia of endothelium accompanied by building up a large group of cells following coagulation necrosis. In group 2, by contrast, an intracellular edema progresses. The cardioprotective effect of isoptin, which is able to block Ca2+, manifests itself most vividly at reperfusion, when the blocking of cell potash overload prevents the development of dystrophic and destructive changes in endothelium of coronary microvessels, which present one of the most severe consequences in the process of blood flow recovery in ischemic tissues.     

Maintenance of left ventricular function (90%) after twenty-four-hour heart preservation with deferoxamine.

During 24-h in vitro heart preservation and reperfusion, irreversible tissue damage occurs caused by reactive oxygen intermediates, such as superoxide radicals, singlet oxygen, hydrogen peroxide, hydroperoxyl, hydroxyl radicals, as well as the peroxynitrite radical. Reduction of the related oxidative damage of reperfused ischemic tissue by free radical scavengers and metal chelators is of primary importance in maintaining heart function. We assessed whether deferoxamine (DFR) added to a cardioplegia solution decreased free radical formation during 24-h cold (5 degrees C) heart preservation and normothermic reperfusion (37 degrees C) in the Langendorff isolated perfused rat heart. The deferoxamine treated hearts were significantly (p less than .001) better preserved than the control hearts after 24 h of preservation with regard to recovery of left ventricular diastolic pressure, contractility (+dP/dt), relaxation (-dP/dt), creatine kinase release, and lipid peroxidation. DFR preserved cell membrane integrity and maintained 93% of left ventricular contractility. The evidence suggests that DFR reduces lipid peroxidation damage by reducing free radical formation and thereby maintaining normal coronary perfusion flow and myocardial function.     

Function of human intrinsic cardiac neurons in situ

We sought to determine the behavior of intrinsic cardiac neurons in human subjects undergoing cardiac surgery and to correlate their activity with hemodynamics status. A lead II electrocardiogram, pulmonary artery pressure, and systemic arterial pressure were recorded along with extracellular activity generated by right atrial neurons in 10 patients undergoing coronary artery bypass surgery. Identified neurons generated spontaneously activity that was, for the most part, unrelated to the cardiac cycle. Most neurons were activated by gentle mechanical distortion of ventricular epicardial loci. The activity generated by neurons in each patient increased when arterial pressure increased and decreased when arterial pressure fell. Intrinsic cardiac neurons continued to generate activity during cardioplegia and cardiopulmonary bypass, but at reduced levels. Normal neuronal activity was restored postbypass. It is concluded that human intrinsic cardiac neurons generate spontaneous activity and that many receive inputs from ventricular mechanosensory neurites. The latter may account for the fact that their behavior depends, in part, on cardiac dynamics. They are also sensitive to intravenously administered pharmacological agents. These data also indicate that cardiopulmonary bypass and cardioplegia do not induce residual depression of their function.     

腺苷和乙酰胆碱后适应诱导的心肌保护作用

近年来缺血后适应的提出成为抗再灌注损伤的里程碑,其良好的临床可控性和可靠的保护效应引起人们广泛关注。缺血后适应即在心肌长时间缺血后再灌注之前,进行数次短暂的再灌注,缺血的循环处理,诱导产生心肌保护效应,其循环次数和间隔时间存在种属差异。研究证实后适应不仅限制急性期梗死面积,还可以减轻长期损伤,其是否与保护血管内皮、抑制中性粒细胞介导的氧化损伤相关还存在争议。上调再灌注损伤补救激酶（reperfusion injury salvageHnase,RISK）通路是后适应保护的重要机制之一,即激活磷脂酰肌醇一3激酶（phosphatidy linositol3-kinase,P13K）-Akt途径和,或细胞外信号调节激酶（extracellular signal-regulatedkinase,ERK）途径,抑制线粒体通透性转换孔的开放,减少细胞凋亡和坏死。但是这两条途径的地位和关系还有待于进一步研究。为了更加适用于临床,研究者将机械调控转变为药物干预,观察药物能否模拟缺血后适应发挥保护作用,即药物后适应。腺苷是研究最广泛,也是最有希望成为临床正式用药的一种药物。我们实验室首先提出了乙酰胆碱可以模拟缺血后适应,通过线粒体ATP敏感钾通道发挥心肌保护效应。本文着重阐述缺血后适应保护缺血,再灌注损伤的效应和信号转导通路,尤其是腺苷和乙酰胆碱模拟药物后适应的可能机制和临床应用。     

An in vitro method for recording the electrical activity of the isolated heart of the adult Drosophila melanogaster

A recording chamber for monitoring the electrophysiological properties of the isolated heart of adult Drosophila melanogaster has been developed. Spontaneously generated field potentials of constant amplitude can be recorded for 6-8 h (n = 14); in very few cases, records were maintained stable for over 10 h (n = 4), and in some cases below 6 h (n = 5). The chamber consists of the tip of a micropipette, which allows for monitoring the field potential generated by the spontaneously contracting heart. The method can produce accurate information about the heart rate and the amplitude of the cardiac action potential. The preparation can be used for pharmacological studies on the heart of D. melanogaster since it responds, with an increase in the heart rate, to unusually low concentrations of octopamine, 1 nM, a compound with cardioaccelerating properties for insect heart. The recording system can be easily modified for experiments on the heart of other insects. Finally, the isolated heart of D. melanogaster provides a simple method for identifying mutations that affect heart physiology.